How many times have you read, or heard, the phrase "sex is just natural" or "sex is a biological fact"? It gets used in science writing, in editorials, in the punch lines of sit-com dialogue. Sex and sexuality are often treated as "natural" things that exist in our world separate from us. If you question this idea the argument you're most likely to get is that humans need to reproduce to survive. That statement is true. But reproducing and sex are not the same thing (and, for the record, there are plenty of ways to reproduce without having sex). Sexuality is complicated and the way we think about it, talk about it, and study it has a huge impact on how we experience it.
A medical model of sexuality refers to a framework or way of thinking and understanding sexuality in general, and individuals lived experience of sexuality in particular. The medical model of sexuality is the dominant model used in the West, it can be hard at first to understand it because it's the way almost everyone talks about sex. But it isn't the only way to think or talk about sex, and it isn't used by everyone. There are lots of other ways, but they tend to get less air time in public discussions.
The medical model constructs sexuality as primarily being a phenomenon that is observable and measurable and in the body. The medical model focuses on sexual functioning and response, reproduction, sexual dysfunction, and approaches sexuality as a "natural" phenomenon that can go "wrong" and then need to be fixed through medical or therapeutic intervention. The medical model approach divides and conquers; difficulties or problems are identified by experts, isolated, and then efforts are made to deal with the individual problem as it has been defined. Central to this model is the idea that there are professionals -- we call them experts -- who know more than you do about your sexuality. You may be broken, but other people can fix you.
The medical model has been described by many people and groups since the practice of medicine became a discipline and industry. In the context of sexuality, disability activists and scholars who work in disability studies have been among the strongest voices pointing out that the medical model is just one approach, and should be contrasted with a social model approach, which understands sexuality as something that is both individual and relational, something that happens in a larger context of social structures of power and privilege.
Benefits of the Medical Model
It is within this medical model that most of the research and technology has developed which both increases individuals quality of life and indeed allows people to live longer and in relatively better health. Taking a medical model approach to sexuality researchers have been able to discover what happens in our bodies when we are being sexual, right down to the cellular level. They are learning about how our bodies change as we age, and when we injure ourselves, or become ill. Some of what they've discovered has been used to increase our capacity to enjoy sex and feel pleasure.
The medical model approach has also allowed doctors and scientists to link our sexual health to other aspects of our physical health. For example, research has discovered that erectile dysfunction can be an early warning sign of other health issues (heart disease, diabetes, high blood pressure, to name a few).
The medical model has also been used in sex education and sex therapy to develop programs and ways of helping individuals and couples to more fully experience their capacity for sexual connection and pleasure.
Drawbacks of the Medical Model
By focusing mostly on individuals (occasionally including one's sexual partner) and considering the body to be the most significant site of sex and sexuality, the medical model often misses fundamental aspects of human experience of sexuality.
We may feel sex in our bodies, but sex and sexuality are not experienced in isolation. Even if we are alone, without a sexual partner, we are sexual beings in relation to others. Our sexuality is influenced by our families (the ones we're born into and the ones we choose), our communities, our friends and lovers. Try to imagine who you would be as a sexual person without all the other influences in your life (for better or worse). By minimizing or ignoring those influences, the medical model denies major parts of people's lived experience of sexuality and compartmentalizes people's experience in a way that gives them fewer, not more, tools for making change.
Because the medical model of sexuality focuses on the individual, it also ignores the social systems and structures that are part of our every day life. Things like gender, race, class, ethnicity, education, sexual identity and orientation, embodiment, religion, all have a huge influence on who we are and how we get to be in the world. The sexual messages and images that surround us, the way that sex is taught (if it's taught at all), who has more or less access to basic sexual rights, all of these things are linked. When we only approach sexuality as an individual condition, we ignore the many ways that our experience and expression of sexuality is molded by others.
Perhaps the greatest drawback of the medical model is that it tends to be ignorant of its own limitations, and most people who work using this model forget that there are other ways to think about sexuality, or at least they think those other ways aren't as important. It is this attitude and approach that keeps the medical model isolated from the rich and ever growing body learning that people and communities are doing for themselves.
